Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes.
Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes.
复制标题
医生与老年患者生活方式讨论的流行率和相关性：ADEPT 录像带分析。
DOI：
10.1016/j.ypmed.2006.06.015
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发表时间：
2006
影响因子：
5.1
通讯作者：
Cook,MaryAnn
中科院分区：
文献类型：
--
作者：
Ory,MarciaG;Yuma,PaulaJ;Hurwicz,Margo-Lea;Jarvis,Crystal;Barron,KateL;Tai-Seale,Tom;Tai-Seale,Ming;Patel,Dhaval;Hackethorn,David;Bramson,Rachel;Street,Richard;Cook,MaryAnn
EQUIPGROUNDThis study identifies the prevalence and correlates of physician-geriatric patient discussions about physical activity and nutrition lifestyle behaviors. METHODS Between August 1998 and July 2000，423 older patient visits to 36 physician were videographed in three different primary care settings.患者样本主要是白色，女性，受过良好教育，经济上足够，虽然12.7%的遭遇发生在市中心的诊所。主要的因变量生活方式的讨论是基于医生的行为观察。在2004年进行了描述性和多变量logistic回归分析。TSNuplanettalk是最普遍的，发生在几乎一半的遭遇（48.2%），其次是身体活动的讨论（39.2%），然后是联合提及（22%）。在紧急访问中，讨论的可能性明显降低。虽然种族、性别和就诊时间没有显着相关性，但在多变量分析中，医生互动方式和患者活力和教育程度是重要的预测因素。结论考虑到生活方式行为对无数健康结果的影响，目前医生讨论的患病率虽然高于许多以前的研究，但仍然不是最佳的。实用的评估工具，培训行为咨询，并报销奖励措施，建议战略提高体力活动和营养的讨论在初级保健设置的患病率。
BACKGROUNDThis study identifies the prevalence and correlates of physician–geriatric patient discussions about physical activity and nutrition lifestyle behaviors.METHODSBetween August 1998 and July 2000, 423 older patient visits to 36 physicians were videotaped in three different primary care settings. The patient sample was primarily white, female, well-educated, and financially sufficient, although 12.7% of the encounters occurred in an inner city clinic. The major dependent variable–lifestyle discussion–is based on observations of physician behavior. Descriptive and multivariate logistic regression analyses were conducted in 2004.RESULTSNutrition talk was most prevalent, occurring in almost half the encounters (48.2%) followed by physical activity discussions (39.2%) then conjoint mention (22%). Discussions were significantly less likely to occur in acute visits. While ethnicity, gender, and length of visit were not significantly related, physician interaction style and patient vitality and education were significant predictors in the multivariate analyses.CONCLUSIONSGiven the impact of lifestyle behaviors on myriad health outcomes, the current prevalence rates of physician discussion, while higher than in many previous studies, remain sub-optimal. Practical assessment tools, training in behavioral counseling, and reimbursement incentives are recommended strategies for raising physical activity and nutrition discussion prevalence in primary care settings.